Belatacept
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Breast cancer and T-cell large granular lymphocytic leukemia: 3 case reports In a retrospective, observational study of kidney transplant recipients (108 patients) converted from unspecified calcineurin inhibitors (CNI) to belatacept between 1 July 2012 and 20 September 2017 with follow-up to 30 April 2018, 3 patients [ages and sexes not stated], were described, who developed breast cancer (2 patients) and T-cell large granular lymphocytic leukemia (1 patient) during immunosuppressant drug therapy with belatacept. The patients were confirmed to be seropositive for Epstein-Barr virus (EBV) before belatacept initiation. The patients had undergone kidney transplantation. The patients were receiving unspecified CNI, which was converted to IV belatacept 5 mg/kg every 4 weeks. The CNI dose was reduced to half after the first belatacept dose and discontinued after the second dose at 4 weeks. Of the three patients, 2 patients, who had received HLA-sensitised (HS) kidney transplant, had received alemtuzumab on the day of the transplantation, along with immune globulin [immunoglobulin; IVIg] and rituximab. Of the 3 patients, two patients developed breast cancer as a side effect of belatacept, of which, one with HS kidney transplantation developed breast cancer 4 years postconversion to belatacept and the other patient with non-HS kidney transplant developed breast cancer at 5 years post-conversion. The third patient with HS kidney transplant developed (predominant) T-cell large granular lymphocytic leukemia as a side effect 2.5years after belatacept conversion and was converted back to unspecified CNI. Sethi S, et al. Outcomes of Conversion From Calcineurin Inhibitor to Belatacept-based Immunosuppression in HLA-sensitized Kidney Transplant Recipients. Transplantation 803515300 104: 1500-1507, No. 7, Jul 2020. Available from: URL: http://doi.org/10.1097/TP.0000000000002976
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Reactions 14 Nov 2020 No. 1830
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